Department of Internal Medicine and Healthcare Research Institute, Healthcare System Gangnam Center Seoul National University Hospital, Seoul, South Korea.
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea.
Dig Dis Sci. 2019 Aug;64(8):2219-2230. doi: 10.1007/s10620-019-05544-3. Epub 2019 Mar 9.
Helicobacter pylori (H. pylori) infection causes extra-gastrointestinal as well as gastric diseases. This analytical cross-sectional study was performed to investigate the association between H. pylori infection and metabolic syndrome in a Korean population.
Anthropometric and metabolic data, as well as anti-H. pylori IgG antibodies, were measured in 21,106 subjects who participated in a health checkup between January 2016 and June 2017. The classification of metabolic syndrome followed the revised National Cholesterol Education Program criteria.
After excluding subjects with a history of H. pylori eradication therapy, or gastric symptoms, the seropositivity of H. pylori was 43.2% in 15,195 subjects. H. pylori-positive participants had significantly higher body mass index (BMI), waist circumference, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and lower high-density lipoprotein (HDL-C) than did seronegative participants (P < 0.05). After adjusting for confounders, high TC, low HDL-C, and high LDL-C were associated with H. pylori seropositivity. Finally, the prevalence of metabolic syndrome was higher in H. pylori-seropositive subjects than in negative ones (27.2% vs. 21.0%, P < 0.05), and H. pylori seropositivity increased the likelihood of metabolic syndrome (OR 1.19, 95% CI 1.09-1.31, P < 0.001) after adjusting for sex, age, BMI, smoking, residence, household income, and education level. However, the association between H. pylori seropositivity and metabolic syndrome disappeared in those ≥ 65 years old.
H. pylori infection plays an independent role in the pathogenesis of metabolic syndrome in Koreans under 65 years old.
幽门螺杆菌（H. pylori）感染除了会引起胃肠道疾病外，还与一些胃肠道外疾病相关。本分析性横断面研究旨在调查韩国人群中 H. pylori 感染与代谢综合征之间的关系。
本研究共纳入 21106 名 2016 年 1 月至 2017 年 6 月期间参加健康检查的受试者，测量了他们的人体测量学和代谢数据以及抗 H. pylori IgG 抗体。采用修订后的国家胆固醇教育计划标准对代谢综合征进行分类。
排除接受过 H. pylori 根除治疗或有胃部症状的患者后，在 15195 名受试者中，H. pylori 血清阳性率为 43.2%。与血清阴性者相比，H. pylori 阳性者的体重指数（BMI）、腰围、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）更高，而高密度脂蛋白（HDL-C）更低（P<0.05）。校正混杂因素后，高 TC、低 HDL-C 和高 LDL-C 与 H. pylori 血清阳性相关。最后，与血清阴性者相比，H. pylori 血清阳性者的代谢综合征患病率更高（27.2% vs. 21.0%，P<0.05），在校正性别、年龄、BMI、吸烟、居住地、家庭收入和教育程度后，H. pylori 血清阳性会增加发生代谢综合征的风险（OR 1.19，95% CI 1.09-1.31，P<0.001）。然而，≥65 岁的人群中 H. pylori 血清阳性与代谢综合征之间的关联消失。
在 65 岁以下的韩国人群中，H. pylori 感染在代谢综合征的发病机制中起独立作用。
